RELATING THE ORGANIZATIONAL CULTURE ASSESSMENT INSTRUMENT TO ADHERENCE IN A PRAGMATIC TRIAL OF A MUSIC INTERVENTION

Abstract Embedded pragmatic trials encourage the translation of evidence-based interventions to “real-world” settings. Most pragmatic trials of behavioral interventions for people with dementia suffer from low adherence. Understanding how organizational values and structure may increase adherence is important. We report findings from an embedded, pragmatic trial (ePCT) of a personalized music intervention for managing behaviors in residents with dementia, conducted in 54 nursing homes (NHs) from four corporations between June 2019 and February 2020. Before the trial began, the administrator and a nursing staff member from each NH completed the Organizational Culture Assessment Instrument (OCAI). Using the OCAI, respondents rated their organizational culture by allocating a total of 100 points across four competing domains: Clan, Adhocracy, Hierarchy, and Market. Results were aggregated to understand how differences in culture impacted corporate-level adoption of the intervention. All four corporations allocated the majority of their points to Clan culture, which is focused on collaboration and staff engagement. However, corporations differed in their scoring of the secondary culture type. The two corporations that rated Hierarchical culture, which prioritizes consistency and efficiency, highly were more likely to adhere to the intervention protocols. The corporation with Market highly rated had the lowest adherence to the protocols. After controlling for other corporate characteristics, including for-profit status, size, and overall quality, hierarchical culture was associated with greater numbers of exposed residents and a higher dose of the music, compared to other culture types. Understanding the role of organizational culture on pragmatic implementation is an understudied area for research.

cognition, depressive symptoms, amount of support received and satisfaction with support with life space mobility.The study included 247 older adults aged 65 and above from the University of Alabama at Birmingham (UAB) Diabetes and Aging Study of Health (DASH).Average age was 73, 45% of the sample were Black/African American, 53% were female, and 47% were married.Results from multiple covariate-adjusted regression analyses revealed that being Black/African American, older, female, and higher depressive symptoms significantly predicted lower life space mobility (all p's < .05)while being married, educated, and reporting better health significantly predicted greater life space mobility.Similarly, higher cognitive function was a significant predictor of greater life space mobility (B = .140,p < .05).Results remained significant even when adjusted for covariates.Amount of support received and satisfaction with support did not predict life space mobility.Findings from this investigation identify individuals who are at risk for restricted life space mobility and suggest protective factors.Establishing these associations with life space mobility within a health disparities framework would be important as it would draw attention to functioning in later life for socially disadvantaged groups and help inform interventions.
Abstract citation ID: igad104.2133Music offers a promising non-pharmacological alternative for managing behavioral dysregulations in people with Alzheimer's disease and other dementias (ADRD).Using data from an embedded, pragmatic trial (ePCT) of a personalized music intervention for nursing home (NH) residents with ADRD, we examined resident and NH characteristics associated with exposure to the intervention and dose of music received.Participants were enrolled from 54 NHs (27 treatment,27 control) between June 2019 and February 2020.The intervention was resident-preferred music delivered at early signs of agitation.Intervention dose was calculated by multiplying song duration and number of plays, averaged over days exposed.Facility and resident-level characteristics were identified using the Minimum Data Set and the Certification and Survey Provider Enhanced Reports.A mixed-effects hurdle model was used.483 residents participated (67.7% female, mean age 79.8±12.2years).Female residents (p=0.04)taking antipsychotic medications (p=0.06) were more likely to receive the intervention, as were residents from NHs with greater nursing involvement (p=0.02).Residents with greater health instability received a greater dose (p=0.04).In this ePCT of a personalized music intervention, NHs with more nursing engagement had greater use of the intervention and appropriately chose residents with antipsychotic use to participate.After adjusting for initial selection, staff used the intervention more frequently with residents who had a higher likelihood of death in the next six months, potentially indicating the beneficial use for comfort at the end of life.Our findings offer insights into future tailoring of personalized music interventions to increase the likelihood of successful implementation.

FACTORS ASSOCIATED WITH THE USE OF A PERSONALIZED MUSIC INTERVENTION FOR NURSING HOME RESIDENTS WITH DEMENTIA
Abstract citation ID: igad104.2134Yochai Shavit 1 , Brett Anderson 2 , and Laura Carstensen 3 , 1. Stanford University,Stanford,California,United States,2. MemorialCare Long Beach Medical Center,Anaheim,California,United States,3. Stanford,Stanford,California,United States Age differences in temporal discounting have long puzzled researchers.Although older adults tend to prioritize the present over the future due to more limited time horizons compared to younger adults there is no evidence for an age association with temporal discounting of monetary rewards.Socioemotional selectivity theory posits that as time horizons become more limited goals related to emotional meaning are prioritized over future-oriented goals because they are realized in the present, leading older adults to place more value on experiences than younger adults.A small body of evidence showing age-related preferences for small, immediate, rewards in emotionally meaningful domains is consistent with SST.However, prior studies used hypothetical tasks with vague trade-offs, limiting their interpretability and generalizability.In the present study, we developed a novel paradigm to examine age differences in temporal discounting of rewards related to emotional experience in a controlled environment.120 participants, aged 22-96 years, came to the lab and made a series of choices indicating if they would prefer to replace 5 minutes of boring tasks with an emotionally meaningful variant of the task today, or a larger amount of time in their next visit in six months.Participants then made similar choices about the timing of receiving comparable monetary rewards.We hypothesized that in contrast to monetary rewards, older adults are less likely than younger adults to wait for rewards related to emotional experiences because time becomes increasingly valued as it grows scarce.Findings support the hypothesis and highlight the role of perceived time-horizons.

OLDER AGE IS ASSOCIATED WITH TEMPORAL DISCOUNTING OF TIME USE BUT NOT MONETARY REWARDS
Abstract citation ID: igad104.2135

RELATING THE ORGANIZATIONAL CULTURE ASSESSMENT INSTRUMENT TO ADHERENCE IN A PRAGMATIC TRIAL OF A MUSIC INTERVENTION Enya Zhu, Ellen McCreedy, Laura Dionne, and Vincent Mor, Brown University School of Public Health, Providence, Rhode Island, United States
Embedded pragmatic trials encourage the translation of evidence-based interventions to "real-world" settings.Most pragmatic trials of behavioral interventions for people with dementia suffer from low adherence.Understanding how organizational values and structure may increase adherence is important.We report findings from an embedded, pragmatic trial (ePCT) of a personalized music intervention for managing behaviors in residents with dementia, conducted in 54 nursing homes (NHs) from four corporations between June 2019 and February 2020.Before the trial began, the administrator and a nursing staff member from each NH completed the Organizational Culture Assessment Instrument (OCAI).Using the OCAI, respondents rated their organizational culture by allocating a total of 100 points across four competing domains: Clan, Adhocracy, Hierarchy, and Market.Results were aggregated to understand how differences in culture impacted corporate-level adoption of the intervention.All four corporations allocated the majority of their points to Clan culture, which is focused on collaboration and staff engagement.However, corporations differed in their scoring of the secondary culture type.The two corporations that rated Hierarchical culture, which prioritizes consistency and efficiency, highly were more likely to adhere to the intervention protocols.The corporation with Market highly rated had the lowest adherence to the protocols.After controlling for other corporate characteristics, including for-profit status, size, and overall quality, hierarchical culture was associated with greater numbers of exposed residents and a higher dose of the music, compared to other culture types.Understanding the role of organizational culture on pragmatic implementation is an understudied area for research.

THE ASSOCIATION BETWEEN COGNITION AND UPPER EXTREMITY MOTOR REACTION TIME IN OLDER ADULTS: A NARRATIVE REVIEW
Alexandria Jones, Natalie Weaver, Mardon So, Abbis Jaffri, and Rosalind Heckman, Creighton University, Omaha, Nebraska, United States Response timing is essential to optimal sensorimotor control across the lifespan.While it is broadly assumed that reaction time increases as cognition declines with age, it is unclear if this assumption is supported by the literature.The purpose of this narrative review was to determine the association between cognition and upper extremity reaction time in older adults.Cognitive domains of sensation and perception, motor construction, perceptual motor function, executive function, attention, learning and memory, and language were considered.We conducted a systematic search using Scopus database.The search strategy was designed to meet four inclusion criteria: 1) community-dwelling adults >60 years, 2) upper extremity motor task, 3) at least one cognitive assessment, 4) simple reaction time measure.1154 articles were screened.Two articles met the full inclusion criteria, but the studies did not associate the cognitive assessment and simple reaction time measures.Nine articles that met three inclusion criteria were reviewed.We found that executive function and learning and memory have been associated with complex and choice reaction time measures.Language, perceptual motor function, and attention have been studied with mixed evidence for an association with reaction time; whereas, sensation and perception and motor construction have not been assessed.Overall, limited research has compared cognitive domain function and simple reaction time to determine if age-related changes are associated.While the complex interplay between cognition and motor function is of substantial interest, these measures are often interdependent and additional knowledge is needed to understand their influence on sensorimotor control with age.

THE EFFECT OF DUAL-TASKS ON WALKING SPEED IN HEALTHY OLDER ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Hyeon Jung Heselton 1 , Adam Rosen 2 , and Julie Blaskewicz Boron 3 , 1. University of Nebraska Omaha, Omaha, Nebraska, United States, 2. University of Nebraska at Omaha,Omaha,Nebraska,United States,3. UNO,Omaha,Nebraska,United States Normative age-related changes occur in both walking and cognitive performance; non-normative changes could lead to decreased mobility, loss of autonomy in daily life, and increased fall risk.This systematic review and metaanalysis aimed to assess the effects of completing a dualtask on overground walking speed in healthy older adults.Database searches were carried out in three electronic databases (PubMed, PsycINFO, ProQuest) from inception through October 2022 to find studies that assessed healthy older adults who completed a walking test and a walking task combined with a neurocognitive assessment (dual-task).Methodological quality and risk of bias was assessed via the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).Cohen's d effect size with a 95% confidence intervals, Cochrane's Q, I2, and Fail-safe N statistics were calculated between the single-and dual-task walking speeds.The initial search yielded 459 articles; six were included in the final review after completing all screening procedures.Included studies had relatively high STROBE scores (19.97±0.82).Eight individual effects across the six articles (total sample size=5627) were calculated.Walking speed significantly decreased in dual-task conditions with cognitive tasks (walking speed Δ=1.03; 95%CI 0.65 to 1.40; p<.001); individual effects were higher during high load cognitive tasks (i.e., serial 7's subtraction, TMT part B).Dual-tasking with a cognitive component clearly affected walking speed in aging adults.Studying different age groups will help create a model of the aging process to understand when changes begin, as well as the rate of change; this could be useful for earlier fall-prevention interventions.

THE LONG-TERM RELATIONSHIP BETWEEN BMI AND COGNITIVE PERFORMANCE: A CROSS-LAGGED PANEL ANALYSIS
Andrew Fiscella 1 , and Ross Andel 2 , 1. University of South Florida, Tampa, Florida, United States, 2. Arizona State University, Tempe, Arizona, United States While obesity has traditionally been associated with negative outcomes, an obesity paradox has been observed which suggests that older adults may show some benefit from having a higher weight.This longitudinal study examined the association between body mass index (BMI) and episodic memory performance.Data from 14,639 participants collected as part of the Health and Retirement Study were used in a 10-year random intercept cross-lagged panel analysis.BMI was used to measure obesity while T-scores from tests of immediate and delayed recall were used to represent episodic memory performance.Initially, a higher BMI was associated with lower episodic memory scores in the following wave (β= -.132, p<.001), but this association became positive over time (β=.142,p< .001)with higher BMI related to better episodic memory scores, even after accounting for demographic and health covariates.The association between BMI and episodic memory over time was stronger in older adults (β=.068, p<.05) than middle-aged adults (β=.020, p=.533).